Loss Of Workforce Research Articles

The Impact of COVID-19-Induced Responsibilities on Women’s Employment in Arab Countries

The COVID-19 pandemic has created massive challenges for women’s employment. Women’s responsibilities were exacerbated by the closure of schools and child daycare facilities. Investigating the determinants of job losses among women is critical to avoiding dropouts and supporting re-entry into the labor market. This study investigates the factors driving women’s workforce losses during the pandemic in five Arab countries (Egypt, Tunisia, Morocco, Jordan, and Sudan). The current study focuses mainly on how COVID-19-induced responsibilities affected women’s employment during the pandemic. The study depends on the COVID-19 MENA Monitor Household Survey produced by the Economic Research Forum. The factor analysis of mixed data is used to construct the women’s responsibilities index that is made up of 18 variables. The mixed-effect logistic model is used to consider changes in working arrangements across economic activities. The results indicate that women with high family caregiving responsibilities were more likely to lose their jobs. Women working in the government sector and with health insurance were protected from job losses. Telecommuting played a significant role in helping women maintain their jobs. Work arrangements should be improved to consider increased unpaid domestic work. Family-friendly policies must be activated, and childcare leave must be facilitated and funded. The private sector should also be urged to improve workplace flexibility.

Comparison of performances of fuzzy logic and adaptive neuro-fuzzy inference system (ANFIS) for estimating employee labor loss

As a result of artificial intelligence research that started in the 1950s, the need for human beings in all sectors and labor markets constantly decreases. The increase in the total cost of the labor force increases the productivity pressure on the labor. For this reason, the workforce participating in production is expected to be more efficient and productive. For this reason, the loss of labor is carefully monitored and tried to be reduced as much as possible. However, with each passing day, labor losses are inevitable due to personnel turnover, work accidents, dismissals, and absenteeism. Humanity is still struggling, mainly due to the contagious covid-19 virus, which has recently affected the world. Since it is a condition that affects human health, its adverse effects have been observed in many areas where people are present. Especially in this period, unpredictable workforce losses have occurred in the production and service sectors since people are mostly the primary workforce. Since there is no plan and measure for such a situation in most risk planning, it also brings labor losses and costs. In this study, In order to examine the relationship between health problems and loss of labor, the amount of lost labor due to employees who could not come to work due to health-related reasons was tried to be estimated by Fuzzy Logic and ANFIS methods. This study examined three-year absenteeism data of employees in a courier company, and twenty-eight reasons for absenteeism were determined. The amount of labor loss was estimated using Fuzzy Logic and ANFIS methods, using five factors that cause absenteeism. Estimated and actual values were statistically compared with MAD MAPE, MSE, and RMSE performance measurement values. With fuzzy logic, the MAD value is 4.76; the MAPE value is 155.7; The MSE value was calculated as 52.7, and the RMSE value as 7.26. In ANFIS, the MAD value is 3.2, the MAPE value of 86.24, MSE of 27.5; The RMSE value was calculated as 5.25. When the results are compared, it has been seen that the ANFIS method obtains closer estimations than the fuzzy logic method.

Kronik Hastalığı Olan Hastalarda Bağırsak Parazitlerinin Değerlendirilmesi

Objective: Parasitic diseases concern all segments of society, especially children in the growing age. Intestinal parasites not only cause mental and physical development retardation, but also cause loss of work force with the complaints they cause, negatively affecting both physical and mental health and the country's economy. In this study, we aimed to evaluate intestinal parasites in patients with chronic diseases. Methods: The files of patients who applied to the internal medicine outpatient clinic between 01.01.2022 and 31.12.2022 and underwent direct stool microscopy in the Parasitology Laboratory of Ordu University Medical Faculty were retrospectively scanned. The patients were divided into 2 groups as those with chronic disease and those without chronic disease. As a chronic disease; Diabetes Mellitus, hypertension, chronic heart disease, chronic heart failure, asthma, chronic obstructive pulmonary disease, other chronic lung diseases, chronic kidney failure, chronic liver failure, goiter diseases, rheumatic diseases were taken as. Socio-demographic characteristics of the patients such as age, gender, educational status, economic status and marital status, and stool microscopic examinations were recorded. Results: 385 patients were evaluated in the study. It consisted of 281 female and 104 male patients. 209 patients with chronic disease were identified. There is a significant relationship between age, marital and educational status and chronic diseases in the comparison of those with and without chronic disease according to their socio-demographic characteristics (P<0.005). Conclusion: There was no significant difference between those with and without chronic disease in terms of intestinal parasites. However, it has been suggested that controlled studies are needed by increasing the number of patients in the patient groups.

SOLUTION OR PROBLEM: A SOCIAL WORK VIEW OF UK FORCED MIGRATION LAW AND POLICY

The UK receives a tiny proportion of the world’s forced migrants and even in Europe is 19th out of 28 countries for numbers received. Nonetheless, immigration is used as a major political issue with public opinion weaponised to achieve the disastrous exit from the European Union. The media narrative encourages the population to believe that there is an ‘invasion’ of people making the highly dangerous journey across the English Channel in small boats and that they are not ’real’ refugees. A plethora of law and policy responses means that individuals are treated differently depending on where they came from, when and how they came. This paper will give a synopsis of the changes to law and policy that proscribe the ‘legal’ and ‘illegal’ routes to the UK for forced migrants. We will consider the outcomes of the financial investment in exclusion (border force, removal centres, planes to Rwanda, British police in France) in the context of a global economic and environmental emergency. Their intended and unintended consequences will be reviewed (destitution and homelessness, Windrush, loss of workforce, social insecurity). Drawing on the five proposals of the People’s Charter for an Eco-Social World presented to the United Nations we propose an alternative approach to migration which values the human agency and capacity of individuals. We give examples from UK and elsewhere to illustrate the success of inclusion over exclusion and offer a reflection on the ability of social work to work within and with contexts. Keywords: Forced migration, strengths approach, social work, eco-social, human rights

Awareness of Ischemic Stroke among Physicians in Primary Care and Emergency Departments

Objective: In particular, ischemic stroke is the primary cause of disability and loss of work force. With intravenous thrombolytic therapy and/or mechanical thrombectomy, stroke is a curable disease. In this study, we evaluated the ischemic stroke awareness of physicians who had first contact with stroke patients. Material and Methods: An online questionnaire of 20 items was applied to collect data. Participation was voluntary, resulting in 66 family physicians and 87 general practitioners. Results: 92.4% of family physicians and 90.8% of general practitioners responded correctly to the item that deals with ischemic stroke symptoms. In the item related to the duration of thrombolytic therapy, the rate of correct response of general practitioners was significantly higher than that of family physicians (p< 0.05). Physicians who worked in the profession for less than 5 years had a significantly higher rate of correct answers than those who worked in the profession for more than 5 years. Conclusion: Today, awareness of family physicians working in primary care and physicians working in emergency services who are in first contact with paralyzed patients should be increased. In addition, patient diagnosis and referral should be focused on. For this purpose, primary care physicians' knowledge on ischemic stroke should be increased. Training should be expanded to raise the awareness of physicians about new developments in stroke prevention, diagnosis and treatment.

Effects of Moderate Exercise Training On ApoE And ApoCIII In Metabolic Syndrome

Introduction: Metabolic syndrome (MetS) is an endocrinopathy with a combination of cardiovascular and metabolic compounds. In our study, it is expected to obtain results showing that mortality rate, loss of workforce, and treatment costs due to disorders caused by MetS can be reduced by physical exercise. The study analyses the effect of moderate exercise training on this Apolipoprotein E (ApoE), Apolipoprotein CIII (ApoCIII), adiponectin, resistin, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) which are thought to have a role in the deterioration of glucose and lipid metabolism in MetS. Methods: This clinical experimental study consists of 3 groups. The MetS+E (n=24) group, which included the participants who agreed to participate in the exercise program in addition to their medical treatment, the MetS (n=23) group who received medical treatment but did not exercise, and the Control+E (n=25) group, which included healthy volunteers who had the same protocol as MetS+E ApoE, ApoCIII, adiponectin, resistin, IL-6, and TNF-α plasma levels of all participants were measured both at the beginning of the study and at the end of the protocol. Results: At the end of the study we reached the following findings; insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) levels decreased in exercise groups (p=0,03). ApoCIII levels increased in all the groups after the study (p<0,01). IL-6 levels decreased in MetS+E (p<0,01) and Control+E (p=0,037). ApoE (p=0,01) and TNF-α (p=0,037) levels decreased only in the Control+E group. Conclusion: Training showed metabolic, anti-inflammatory, and physical improvements independent of ApoE and ApoCIII in those with MetS.

Electroencephalogram-Based Major Depressive Disorder Classification Using Convolutional Neural Network and Transfer Learning

Major Depressive Disorder (MDD) is a worldwide common disease with a high risk of becoming chronic, suicidal, and recurrence, with serious consequences such as loss of workforce. Objective tests such as EEG, EKG, brain MRI, and Doppler USG are used to aid diagnosis in MDD detection. With advances in artificial intelligence and sample data from objective testing for depression, an early depression detection system can be developed as a way to reduce the number of individuals affected by MDD. In this study, MDD was tried to be diagnosed automatically with a deep learning-based approach using EEG signals. In the study, 3-channel modma dataset was used as a dataset. Modma dataset consists of EEG signals of 29 controls and 26 MDD patients. ResNet18 convolutional neural network was used for feature extraction. The ReliefF algorithm is used for feature selection. In the classification phase, kNN was preferred. The accuracy was yielded 95.65% for Channel 1, 87.00% for Channel 2, and 86.94% for Channel 3.

Intervertebral disc cell fate during aging and degeneration: apoptosis, senescence, and autophagy

Degenerative disc disease, a major cause of low back pain and associated neurological symptoms, is a global health problem with the high morbidity, workforce loss, and socioeconomic burden. The present surgical strategy of disc resection and/or spinal fusion results in the functional loss of load, shock absorption, and movement; therefore, the development of new biological therapies is demanded. This achievement requires the understanding of intervertebral disc cell fate during aging and degeneration. Literature review was performed to clarify the current concepts and future perspectives of disc cell fate, focused on apoptosis, senescence, and autophagy. The intervertebral disc has a complex structure with the nucleus pulposus (NP), annulus fibrosus (AF), and cartilage endplates. While the AF arises from the mesenchyme, the NP originates from the notochord. Human disc NP notochordal phenotype disappears in adolescence, accompanied with cell death induction and chondrocyte proliferation. Discs morphologically and biochemically degenerate from early childhood as well, thereby suggesting a possible involvement of cell fate including age-related phenotypic changes in the disease process. As the disc is the largest avascular organ in the body, nutrient deprivation is a suspected contributor to degeneration. During aging and degeneration, disc cells undergo senescence, irreversible growth arrest, producing proinflammatory cytokines and matrix-degradative enzymes. Excessive stress ultimately leads to programmed cell death including apoptosis, necroptosis, pyroptosis, and ferroptosis. Autophagy, the intracellular degradation and recycling system, plays a role in maintaining cell homeostasis. While the incidence of apoptosis and senescence increases with age and degeneration severity, autophagy can be activated earlier, in response to limited nutrition and inflammation, but impaired in aged, degenerated discs. The phosphatidylinositol 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) is a signal integrator to determine disc cell fate. Cell fate and microenvironmental regulation by modulating PI3K/Akt/mTOR signaling is a potential biological treatment for degenerative disc disease.

Evaluation of sharp injuries in healthcare professionals

Aims: We carried out this descriptive study to retrospectively explore the occupational accidents in our hospital between January 01, 2016 - December 31, 2019. Methods: We present the descriptive statistics as means, standard deviations, frequencies, and percentages. Results: While 49.3% of the participants were aged 18-29 years, 75.2% were females. About half of the participants (52.2%) held a secondaryschool diploma. While 31.3% worked as trainee nurses, 24.4% were employed as nurses. Similarly, approximately half of the participants (48.9%) were deployed in clinics, and 16.0% engaged in care in intensive care units. Given the way the participants experienced the occupational accident, 53.3% were injured with a needle-stick (syringe/branule) and 21.9% with a lancet. Conclusion: It is well-known that sharp object injuries constitute a significant portion of occupational accidents occurring to healthcare professionals. Accordingly, the measures to be adopted to prevent such undesirable situations may be led by uncovering the frequency of and underlying factors for sharp object injuries, causing worries among healthcare professionals and loss of workforce and even death.

A different indication of pisphosphonates: Bone marrow edema

Abstract Introduction Bone marrow edema (BME) is an uncommonly diagnosed, reversible condition most often affecting the hip of middle-aged men. BME is characterized clinically by the onset of disabling bone pain, usually at a single skeletal site, generally in the lower limbs and most often the hip. Diagnosis is often delayed. The increased bone turnover and low bone mineral density may indicate a potential role for bisphosphonate therapy in BME. There is some evidence of the successful use of intravenous bisphosphonates in the treatment of BME of the hip. We aimed to present two cases of BME that were successfully treated with bisphosphonates. Clinical Case 1: A 41-year-old male patient presented with left inguinal pain. His past medical history was unremarkable. The visual analog scale (VAS) was 8–9. On physical examination, there was a limited range of motion (ROM) on the left hip. Laboratory results were within normal limits. Non-contrast MRI revealed signal intensity changes consistent with BME in the left femoral head and neck of the femur, which was hypointense in T1W sections and hyperintense in T2W sections. With assisted mobilization, 3 mg IV ibandronic acid, calcium and vitamin D replacement was started. Pain control was achieved one week after bisphosphonate infusion. Complete resolution of bone marrow edema was seen in the MRI taken 2 months later (Figure 1). Bisphosphonate treatment with alendronate was completed for one year. Clinical Case 2: A 59-year-old male patient presented with right hip pain that limits his walking. He was diagnosed with BME and avascular necrosis as a result of clinical and radiological evaluation in the center he applied and he underwent a right femoral core decompression operation. He was evaluated in our clinic due to ongoing pain and limitation of movement 5 months after the operation. On physical examination, there was limited ROM on right hip. All the results of laboratory tests were normal. MRI revealed signal changes consistent with bone marrow edema in the right femoral head and neck of the femur, which was hypointense in T1W sections and hyperintense in T2W sections. With assisted mobilization, 3 mg IV ibandronic acid, calcium and vitamin D replacement was started. Pain control was achieved 10 days after bisphosphonate infusion, and he returned to working life 1 month later. Complete resolution of the BME was observed in MRI performed 10 weeks later. Completion of the bisphosphonate treatment with alendronate for 1 year was planned. Conclusion The hip is the most frequently involved joint, with diffuse BME pattern in the femoral head and intertrochanteric region observed on MRI. BME may be a precursor to avascular necrosis when the diagnosis is delayed or the treatment is not well managed. Therefore, optimal timing of medical intervention is very important. Treatment with bisphosphonates is an effective and safe treatment. Additionally, providing early mobilization may prevent the risk of avascular necrosis and the workforce loss.

New Hopes in Psychopharmacology

Psychiatric disorders are very common all over the world, cause significant disability, and impose a heavy burden on both the individual and the society due to the loss of workforce. Unlike other diseases, phenomenological structure is still used in the diagnosis of mental disorders. The etiology of psychiatric disorders is not fully known. Because of this situation, treatment for the etiology cannot be performed. Treatment of psychiatric disorders differs from person to person, according to genetic characteristics. Existing treatment approaches take time to take effect, and resistance and unresponsiveness to treatment constitute serious problems in a significant portion of patients. Understanding the etiology and psychopathological processes of mental disorders is extremely important in terms of developing new treatment strategies. The number of studies aimed at understanding the neurobiology of psychiatric disorders is increasing rapidly. New pharmacological approaches in the treatment of obesity, delirium and sleep disorders, which have come to the fore in this field in recent years, have created excitement. Studies examining the effects of naltrexone/bupropion and phentermine/topiramate extended-release forms in the treatment of obesity are promising. Similarly, it is interesting to suggest that dexmedetomidine, a selective alpha 2 adrenergic agonist agent, may be a suitable option for the treatment of delirium. One of the promising psychopharmacological treatment approaches in recent years is the use of Orexin Receptor Antagonists (ORAs) in the treatment of insomnia. It has the potential to revolutionize the pharmacological treatment of insomnia. In this article, it is aimed to contribute to the literature by reviewing studies on current and new pharmacological treatment approaches in the treatment of obesity, delirium and insomnia.

LABOUR MARKET DYNAMICS IN UKRAINE DURING WAR: ANALYSIS OF MIGRATION TRENDS AND UNEMPLOYMENT INDICATORS

Purpose. The aim of this study is to determine the influence of the wartime period on Ukraine's labour market, analyse key transformations and imbalances resulting from changes in the socio-economic context, and identify potential ways to overcome negative consequences and support labour market stability in the conditions of a military conflict. Methodology of research. Scientific methods and techniques were employed to analyse the impact of the military conflict on Ukraine's labour market. The primary research methods included: analysis of statistical data provided by the State Statistics Service of Ukraine, the Ukrainian Institute for the Future, the United Nations Population Fund, and the United Nations Refugee Agency for assessing unemployment rates and other demographic indicators; forecasting based on data from the National Bank of Ukraine to predict possible future labour market scenarios; and analysis of social aspects to determine the impact of the military conflict on unemployment, population consumption capacity, national income, and other socio-economic aspects. Findings. It is substantiated that the consequences of the conflict have led to a decrease in Ukraine's population, with the population estimated to range from 29 to 34 million individuals as of 2023. It has been proven that the impact of the military conflict resulted in an increase in unemployment, reaching a critical level of 25.8% in 2022, but due to special rehabilitation measures, this figure decreased to 21.1% in the second half of 2022. The conflict has also intensified migration processes, affecting the distribution of the workforce and creating additional challenges in the labour market. It was analysed that post-conflict labour market reconstruction becomes a complex task, with many individuals seeking new job opportunities requiring requalification and skill development. Overcoming unemployment issues and stabilizing the labour market in conflict conditions require a comprehensive approach. Supporting businesses, increasing productivity, and ensuring stability can contribute to resolving these problems. Originality. The study has advanced the understanding of the impact of the military conflict on Ukraine's labour market, including significant workforce losses and the possibility of exceeding the number of retirees compared to working individuals. Approaches to overcoming negative consequences and supporting labour market stability in conflict conditions have been enhanced by promoting an inclusive labour market, considering workforce shortages, retraining, and increasing the representation of vulnerable groups in the labour market. Practical value. The research results provide a scientific and practical foundation for developing strategies to rehabilitate the labour market in the context of a military conflict. The conclusions of this article can serve as a basis for further research and the development of policies aimed at supporting the workforce, reducing unemployment, and ensuring labour market stability during the negative impacts of a military conflict. Key words: labour market, Ukraine, population size, labour potential, unemployment, economic consequences, labour market rehabilitation, migration, comprehensive approach

Is Brain MRI Essential for the Evaluation of Headache in Patients with Normal Neurological Examination?

Aim: Headache is amongst the most common reasons of consulting a doctor. In addition to impairing the quality of life of the individual, there are societal as well as fiscal outcomes like workforce loss along with health expenditures. MRI findings of patients with headache were examined retrospectively through the relevant literature with a view to scrutinizing the necessity of the very procedure carried out, and the results were shared accordingly. Through our study we delved into the recent situation in our country and investigated whether MRI devices with advancing and novel technologies give dissimilar results with diffusion and sensitivity-weighted images in the MRI findings of patients who seek medical advice visiting a health institution with complaint of headache. Materials and Methods: The study included 224 patients over the age of 18, who underwent brain MRI between January 2020 and December 2021 in our center, with normal findings on neurological examination and who had not undergone surgery. All abnormal appearances such as mass, metastasis, aneurysm, hydrocephalus, encephalitis, sinusitis, mastoiditis, otitis, which may cause secondary headache, were recorded in MR images. Results: Of the 224 patients, 120 (53.57%) were male and 104 (46.43%) were female. The mean age was 39.45±12.55 years. None of the 224 examinations revealed mass suspicious for malignancy, aneurysm, encephalitis, or meningitis. Extraaxial mass lesion compatible with meningioma was detected in 3 patients (1.33%), arachnoid cyst in 3 patients (1.33%), and developmental venous anomaly in 2 patients (0.89%). There was paranasal sinus infection in 145 patients (64.73%), mastoiditis in 37 patients (16.52%), and otitis in 8 patients (3.57%). The remaining 66 patients had no MRI findings except ischemic-gliotic changes, enlarged perivascular distances, and physiological calcifications. Conclusion: In studies designed according to CT and MRI examinations taken regardless of neurological examination and history, the rate of completely normal findings is quite high, as in our study. MRI scans conducted for these patients, who can indeed solely be diagnosed with examination or simpler imaging methods, lead to loss of time and money. In order to fix the said situation, we are of the opinion that the red flag practice should become widespread and nonessential examination requests should be supervised.

APPLICATION OF REBA AND KARAKURI KAIZEN TECHNIQUES TO REDUCE ERGONOMIC RISK LEVELS IN A WORKPLACE

Repetitive works and the works done with inappropriate body postures cause musculoskeletal disorders and workforce losses. Design, technology, and humans must come together in ergonomic conditions. In this study, the ergonomic risk levels that employees in automotive production lines being exposed to were determined by the rapid entire body assessment (REBA) method and by considering anthropometric measurements and ergonomic body postures at a line with high risk level, and a shelf system was designed in accordance with the Karakuri working principle. Through the computer-aided design, the system operation was simulated and solutions for ergonomic risks could be provided before the production. The ergonomic risk level, which was “high” in the current situation, could be reduced with the newly designed mechanism, and an ergonomic workspace could be provided for employees. In the new situation, the ergonomic risk level is “low.” In addition to ergonomic improvements, as the manual transportation works of the employee were eliminated, the cycle time of the line, which was 120 s in the first state, was reduced to 100 s after the use of the Karakuri mechanism and the efficiency of the line increases by 17%.

Detection of Tonsillopharyngitis with Grad-Cam and Optimization-Based Model Using Oropharyngeal Images

Tonsillopharyngitis is a sudden onset contagious infection of the pharynx and tonsils. Patients experience a rapid general condition and loss of workforce. In addition to affecting patients, it spreads and affects other individuals. In addition, it causes severe complications and increases hospital costs. Therefore, early and accurate diagnosis is essential. In this study, a hybrid model is developed for the diagnosis of tonsillopharyngitis. First, the heat maps of the images in the original data set by applying the Gradient-weighted Class Activation Mapping (Grad-Cam) method. In the proposed model, feature maps are obtained from the original and heatmap datasets using the Darknet53 architecture as the base. It is aimed to increase the performance of the proposed model by bringing together different features of the same image. After the feature map obtained after the feature fusion step is optimized with the Relief method, classification is carried out using an SVM shallow classifier.

Illness perception and quality of life in patients with migraine and tension-type headache

ABSTRACT Introduction Migraine and tension-type headache (TTH) are important health problems because cause loss of workforce, affect quality of life and are frequently associated with anxiety and depression. Illness perception is defined as a cognitive aspect of illness. The aim of this study is to determinethe relationship of migraine and TTH with quality of life, illness perception, anxiety and depression. Materials and Methods Demographic information and headache characteristics of 160 patients (80 migraine, 80 TTH) who has applied to our hospital’s neurology outpatient clinics were recorded. Hospital anxiety depression scale, illness perception questionnaire and quality of life short form-36 (SF-36) were applied to these patients. Results Headache severity and duration were higher in migraine patients. Migraine sufferers believed that their illness would last longer and the results would be worse. Negative emotional representations were more common in TTH patients. Understanding of the disease was higher in younger and those with higher levels of education. Social functionality and bodily pain scores were worse than those of TTH patients. Headache severity and duration were higher in women. Anxiety and depression were associated with headache frequency, duration, and severity. It was determined that the severity, duration and frequency of headache also affected the quality of life. Conclusion Informing patients in detail about their diseases and increasing their education level can contribute to the improvement of headache representations. In addition, screening and treatment of anxiety and depression may be other interventions that can improve patients’ adherence to treatment and quality of life.

The Impending Collapse of Primary Care: When is Someone Going to Notice?

For 2 years, the Larry A. Green Center conducted weekly to monthly surveys among a national sample of primary medical care practices on how they were faring during the on-going COVID-19 pandemic in the United States. As both a family physician and as one of the analysts of these surveys and the thousands of detailed comments accompanying them, I witnessed a courageous, professional, and deeply distressing saga. The most recent surveys hint at an impending collapse of primary medical care as we have known it. This Commentary reflects what I heard, from remarkable efforts to rapidly implement virtual care platforms and reach out to vulnerable patients in the face of workforce losses and inadequate assistance including lack of personal protective equipment to a sense of betrayal when vaccines finally arrived but primary medical care was, too often, left out of the distribution efforts. The last surveys highlighted a loss of primary care workforce and the potential collapse of relationship-centered primary medical care. One of the respondents asks, "When is someone going to notice?"Three areas for change are recommended. Build a larger, more diverse primary medical care workforce. Emphasize capitation as a foundation for payment reform in primary medical care. Establish primary health care extension services that focus on supporting practices and in helping them integrate with public health and their communities. Listening to each other, let us rise together with our patients and be noticed.

Assessment of the factors affecting the loss of workforce in patients with traumatic hand injury

Objective: This study aimed to examine the factors affecting the loss of workforce, including the time to return to work and workrelated situations in patients with traumatic hand injury who were taken to a hand rehabilitation program. Materials and Methods: The patients aged between 18-65 years with a history of traumatic hand injury in the last five years were analyzed retrospectively. Demographic and clinic data were taken from the medical records, and work-related problems were obtained by telephone calls. The severity of hand injury was assessed with Modified Hand Injury Severity Score (MHISS). Results: A total of 147 patients (129 males, 18 females; mean age 39.83±10.4 years) were included. The duration of return to work was correlated with total MHISS (rho=0.262 p=0.003) while not related to age, education level, gender, or injured hand’s dominance (p>0.05). Duration of return to work after hand injury and total MHISS were lower in the patients who had job modifications (p<0.001, p=0.002). Job modification rate, salary reduction, and patient-reported hand dexterity loss were higher in patients with work-related injuries (p<0.05). Conclusion: This study highlighted that the increasing severity of hand injury caused a prolonged time to return to work, or job scope changes.

Current Perspectives on the Impact of Chronic Migraine on Sleep Quality: A Literature Review.

ObjectiveRecent studies have shown that sleep problems occur in migraineurs and poor sleep causes chronification, but the mechanisms by which chronic migraine affects sleep quality are still unknown. This review aims to analyze commonly reported sleep disturbances in chronic migraine (CM) and determine the effect of CM on sleep quality.Materials and MethodsWe conducted a comprehensive review of all published articles on CM and sleep quality from inception to March 2022 in the literature. Clinical trials, observational studies, and case series (≥20 cases) were included. Two reviewers and a supervisor reviewed the titles and abstracts of all search results with predefined inclusion and exclusion criteria. PubMed search for randomized controlled trials and open studies on CM and sleep quality reported in English between 1983 and 2022 was conducted using the keywords including chronic migraine, sleep, insomnia, sleep quality, polysomnography, and Pittsburgh Sleep Quality Index.ResultsA total of 535 potentially relevant articles were found. A total of 455 articles and reviews, meta-analyses published in any language other than English, with other exclusion criteria, were excluded from the review. In the remaining articles, 36 clinical studies, reviewing sleep quality and its association with migraine, were identified and reviewed. Evidence from this review shows that poor sleep and migraine chronicity are intertwined with other accompanying comorbidities and dysregulation of circadian rhythm that innovative treatments promise to bring relief to both poor sleep as well as migraine.ConclusionSleep disorders are common in CM and the association between migraine chronification and sleep quality is bidirectional. Comorbid conditions with accompanying frequent attacks in migraine may impair sleep quality. While the maladaptive pain process worsens sleep, poor sleep quality also negatively affects migraine pain. Sleep disturbance, which is affected by worsening migraine attacks, causes deterioration in the quality of life, loss of workforce, and economic burden.

An assessment on loss of workforce due to COVID-19 among healthcare personnel: A university hospital experience.

Healthcare personnel are among the COVID-19 risk groups. For this reason, increased absence from work affects the loss of labor. This study aimed to evaluate the workforce loss amongst health personnel working in our hospital due to COVID-19 in a one-year period. Workforce loss of healthcare workers was assessed via absenteeism and life expectancy. Loss of workforce for COVID-19 PCR positive or PCR negative but CT findings compatible with COVID-19 and personnel with high-risk exposure for COVID-19 were determined with absenteeism. Healthcare personnel who passed away due to COVID-19 was determined with the consideration of the retirement age and expected life years. Total lost time from work was 14635 days (excluding deaths). Loss of workforce rates resulting from COVID-19 positivity for male employees was greater in comparison to the results for females (p = 0.018). High-risk exposure of healthcare personnel working in clinical sciences was higher than those in other departments (p < 0.001). Total loss in workforce for 3 people passed away was 14 years 5 months, and total life expectancy was 64 years. Healthcare personnel under the age of 40 had less absenteeism than those over 40 years (p < 0.001). It was observed that all occupational groups working at the hospital were impacted by COVID-19. The two most important factors that influenced absenteeism were the reason for being affected (positivity and high risk) and age. Absenteeism and daily case tracing of healthcare personnel working on the frontlines will aid in both the pandemic control and management of workload for those left behind.